Arthroscopic meniscal repair versus partial meniscectomy for middle-aged patients with meniscal tears and type 2 diabetes mellitus: A retrospective study on mid-to-long-term outcomes and prognostic factors

The meniscus plays a critical role in maintaining knee joint stability, absorbing shock, and distributing load-bearing stress. Middle-aged individuals are prone to meniscal tears due to degenerative changes, while type 2 diabetes mellitus (T2DM), a prevalent chronic metabolic disorder, may impair cartilage healing and postoperative recovery, potentially compromising surgical outcomes. However, comparative evidence regarding arthroscopic meniscal repair versus partial meniscectomy in this specific population remains limited. This retrospective cohort study included 122 middle-aged patients with T2DM who underwent arthroscopic treatment for meniscal tears at our center between January 2023 and May 2024. Patients were divided into a repair group (n = 62) and a resection group (n = 60) based on the surgical procedure. Clinical outcomes within 12 months postoperatively were compared, including knee function (Lysholm and International Knee Documentation Committee scores), pain relief (Visual Analog Scale score), complication rate, and magnetic resonance imaging-based imaging findings. Multivariate logistic regression analysis was performed to identify independent predictors of functional recovery. Baseline characteristics were comparable between groups (all P > .05). At both 6 and 12 months postoperatively, the repair group showed significantly better Lysholm and International Knee Documentation Committee scores compared to the resection group (P < .001), along with consistently lower Visual Analog Scale scores (P < .01). Magnetic resonance imaging follow-up revealed a lower rate of cartilage degeneration in the repair group (Outerbridge grade ≥ 2: 16.1% vs 30.0%, P = .048), and the meniscal healing rate reached 85.5%. Complication rates were similar between groups (9.7% vs 11.7%, P = .71). Multivariate analysis identified surgical approach (repair: odds ratio [OR] = 1.92, P = .016), diabetes duration >10 years (OR = 1.78, P = .022), and preoperative glycated hemoglobin >7.5% (OR = 1.66, P = .031) as independent predictors of functional outcome. In middle-aged patients with T2DM and meniscal tears, arthroscopic meniscal repair offers superior outcomes in terms of functional recovery, pain relief, and cartilage preservation compared to partial meniscectomy, with comparable safety profiles. Patients with better glycemic control and shorter diabetes duration are more likely to benefit, supporting the preference for tissue-preserving strategies when feasible.